1.Is the National Early Warning Score applicable to patients with trauma?
Ja Hyoen SUH ; Dong Hoon KIM ; Changwoo KANG ; Soo Hoon LEE ; Jin Hee JEONG ; Taeyun KIM ; Sang Bong LEE ; Seong Chun KIM
Journal of the Korean Society of Emergency Medicine 2019;30(6):563-568
OBJECTIVE:
The National Early Warning Score (NEWS) is used widely to detect deteriorating patients in a range of clinical situations. This study examined the ability of the NEWS to predict poor outcomes in trauma patients.
METHODS:
This was a retrospective observational study using a dataset collected prospectively from trauma patients who visited the emergency department of a tertiary referral center in the southern area of the Republic of Korea. The area under the receiver operating curves (AUC) of the Revised Trauma Score (RTS) and NEWS were compared. The primary outcome was in-hospital mortality.
RESULTS:
Among 17,661 patients finally enrolled, 66.3% were male, and the median age was 49 (34-64). The AUC of the NEWS and RTS were 0.878 (95% confidence interval [CI], 0.873–0.883) and 0.827 (95% CI, 0.821–0.833) (AUC difference, 0.051; 95% CI, 0.025–0.077; P<0.01), respectively. The sensitivity and specificity of the NEWS were 74.0% and 91.2%, respectively, at a cutoff of four, and those of the RTS were 67.7% and 96.1%, respectively, at 7.55.
CONCLUSION
The NEWS showed better performance in predicting the in-hospital mortality of patients with trauma compared to the RTS.
2.Initial Serum Ammonia as a Predictor of Mortality in Patients with Acute Glufosinate Ammonium Herbicide Poisoning
Eun Na LAE KO ; Dong Hoon KIM ; Soo Hoon LEE ; Jin Hee JEONG ; Sang Bong LEE ; Aejin SUNG ; Ja Hyoen SUH ; Changwoo KANG
Journal of The Korean Society of Clinical Toxicology 2020;18(2):136-140
Purpose:
The association of the initial serum ammonia level with in-hospital mortality in patients with acute glufosinate-ammonium herbicide poisoning was studied.
Methods:
This retrospective cohort study was conducted between March 2012 and August 2019 in the emergency department after glufosinate-ammonium herbicide poisoning. Survivors and non-survivors were analyzed using a Mann-Whitney U test and Fisher’s exact test. Multivariate logistic regression analysis was performed to determine the independent risk factors for mortality.
Results:
One hundred and six patients were enrolled; 11 died, yielding a mortality of 10.4%. The serum bicarbonate level was significantly lower in the non-survival group than the survival group. Age, serum ammonia, blood urea nitrogen, creatinine levels, SOFA score, and APACHE II score were significantly higher in the non-survival group than the survival group. Age, serum ammonia, and creatinine level were independent risk factors for mortality in multivariate logistic regression analysis.
Conclusion
The initial serum ammonia level is associated with mortality in patients with acute glufosinate herbicide poisoning.
3.Initial Serum Ammonia as a Predictor of Mortality in Patients with Acute Glufosinate Ammonium Herbicide Poisoning
Eun Na LAE KO ; Dong Hoon KIM ; Soo Hoon LEE ; Jin Hee JEONG ; Sang Bong LEE ; Aejin SUNG ; Ja Hyoen SUH ; Changwoo KANG
Journal of The Korean Society of Clinical Toxicology 2020;18(2):136-140
Purpose:
The association of the initial serum ammonia level with in-hospital mortality in patients with acute glufosinate-ammonium herbicide poisoning was studied.
Methods:
This retrospective cohort study was conducted between March 2012 and August 2019 in the emergency department after glufosinate-ammonium herbicide poisoning. Survivors and non-survivors were analyzed using a Mann-Whitney U test and Fisher’s exact test. Multivariate logistic regression analysis was performed to determine the independent risk factors for mortality.
Results:
One hundred and six patients were enrolled; 11 died, yielding a mortality of 10.4%. The serum bicarbonate level was significantly lower in the non-survival group than the survival group. Age, serum ammonia, blood urea nitrogen, creatinine levels, SOFA score, and APACHE II score were significantly higher in the non-survival group than the survival group. Age, serum ammonia, and creatinine level were independent risk factors for mortality in multivariate logistic regression analysis.
Conclusion
The initial serum ammonia level is associated with mortality in patients with acute glufosinate herbicide poisoning.